Earlier this week, ABC News reported ran a story with the headline “Baltimore Boy’s Death Raises Concerns Over Cold Virus”. The story is scary because what started as a common cold for third grader Anthony Scott progressed to an asthma attack and he, sadly, died.
His community was understandably panicked because his illness did begin as a common cold from adenovirus and a child did die. However, the public health officials in his community have also gone on record stating that the adenovirus Anthony had was not a contributor to his death, making other causes like asthma more likely.
The real story here is not that colds are dangerous, but that colds can be dangerous in the right setting for people who have underlying issues, like asthma or a weakened immune system. Those are the people we worry about during cold and flu season.
For children with asthma, cold and flu season is often a tricky season. This is one of the reasons pediatricians work tirelessly to educate parents and children about asthma and try so hard to control the symptoms in children who have asthma. And, with good reason. The latest CDC asthma statistics tell a story of a disease that packs a punch on families and society:
- As of 2003, 6.5 million children have asthma in the United States.
- There 12.8 million missed school days for kids and 10.1 missed work days for parents.
- In 2004, kids had 7.0 million doctors office visits, 754,000 ER visits, and 198,000 hospitalizations.
- Deaths from asthma in kids is rare but do occur. In 2003, 195 kids did die as a result of an asthma attack.
Parents often panic when their children are diagnosed with asthma. The first question a parent typically asks me is “will he or she out growth this?” The honest truth is, often not. Asthma has a funny way of returning when a family least expects it and those are the times asthma attacks are the worst. I know too many adults who have found themselves in some real pickles because their “childhood asthma” came back. Well, it’s not really that their childhood asthma came back it’s that they had asthma their entire lives but was never really explained that as a child so didn’t know what to do as an adult.
So, what is asthma? Asthma is recurrent wheezing from a trigger. Triggers vary among children but typical categories include illnesses, season changes, pets, smoke, sports, allergens, foods, drugs. Some children have one or two triggers while others have many. Some children stick to one trigger while others change over time. What is important is to remember that with asthma the airways wheezes with a trigger and to always have your child’s medications on hand to be prepared.
With asthma, the issue is with the tubes of the airways. Those airways are tubes and those tubes get small and swollen with asthma and that’s what produces the wheezing sound when a child tries to breath. Medications are aimed at getting the airways back to their normal size and at clearing out the swelling. Inhalers with bronchodilator medication (albuterol) is the first line medication, the rescue medication, used to get the airways big quickly to get air into the child but what really clears the asthma attack is the steroid. Steroids are the only way for the airways to get to their normal size. What’s cool is that we know a great deal about steroids and have the dose fine-tuned so that the child will not be harmed in a long-term way by the few days of steroid needed to clear the airways. And, the dose is not that high – just high enough to get the child breathing well again!
The severity of asthma attacks is also variable per child. The key is to call your pediatrician early if the medication you were given is not working within the first day. And, to call right away if your child has labored breathing. Asthma is one of the few possible 911 moments in childhood so if you are really worried about how your child looks with labored breathing, don’t wait it out until the next office appointment, call for help. Remember, we’re talking about a child’s airways and ability to get oxygen.
In the end, most kids can do really well with asthma if a family understands the medications and has an action plan. If you have any questions about your child’s asthma, or don’t have an asthma action plan, call your pediatrician today. And, if your child has asthma, your child and everyone else in the family over 6 months of age needs to get a flu shot.
For more information on childhood asthma, click here.